Analysis of functional outcome of single and double level lumbar discectomy

Abstract

Introduction:  Functional improvement in lumbar PIVD patients can be assessed either objectively like improvement in SLRT, relief in pain, etc or subjectively using different types of scales. In our study, we have used Revised Oswestry Disability Index (RODI) score, Ronald–Morris disability questionnaire (RDQ), The Back Bournemouth Questionnaire (BQ) to analyse functional outcome in single and double level lumbar PIVD patients pre-operatively and post-operatively. Method:  It is a prospective study including 80 patients of lumbar PIVD who failed to respond to conservative treatment.  Patients were clinically evaluated and disability scales viz- RODI, RDQ & BQ were recorded. After lumber discectomy, patients were again assessed and scored as per disability scales at 1 month, 6 months and 1 year postoperatively. Result:  RODI, RDQ and BQ scores were calculated at pre-operatively and post-operatively 1, 6 and 12 months and statistically analysed. The mean RODI scores at pre-operative and postoperative 1, 6, and 12 months were 72, 18, 10, and 6 respectively. The mean RDQ scores at pre-operative and postoperative 1, 6, and 12 months were 15, 5, 3, and 2 respectively.  Similarly, the mean BQ scores at pre-operative and postoperative 1, 6, and 12 months were 51, 12, 8, and 4 respectively.  Statistically, significant improvement was seen in mean scores of all 3 functional scales and maximum changes were observed after 1 month. Statistically, significant improvements were observed in 54 out of 62 patients (87%). Three questions of BQ related to the patient social and family activities, anxiety and depression were separately compared pre and post-operatively and they showed a statistically significant improvement. Conclusion: Overall 87% of patients had a significant improvement in functional assessment using RODI, RDQ and BQ scales. On comparing single and double level discectomy patients, the functional improvement was similar in follow up of one year. Social and family activities (SFA), depression and anxiety of the patients improved significantly over 1 year.